The VA National Bed Control System records the levels of operating, unavailable and authorized beds at each VAMC, and it tracks requests for changes in these levels. For changes in operating, unavailable and authorized bed levels, the Director of a Medical Center or his/her authorized delegate enters a bed change request into the Bed Control Database. A Bed Control Database trigger automatically notifies the respective Veterans Integrated Support Network (VISN) director. The VISN director's designated staff reviews the request and either approves, disapproves, or cancels it through the Bed Control Database. If a medical center request is approved by the VISN director, a Bed Control Database trigger notifies staff in the Assistant Deputy Under Secretary for Health for Operations and Management (10N) to review and take action, followed by the appropriate VHA Program Office and then the Under Secretary for Health. Once a request has been approved, cancelled, or disapproved by either the Deputy Under Secretary for Health for Operations and Management, VHA Program Office, or the Under Secretary for Health, the medical center director and the appropriate VISN director are automatically notified of the action. The approval process is tracked and visible to the authorized user of the system. When changes are approved, the database updates its bed level information accordingly. Pertinent justification and documents associated with each bed change request are stored in the database.